Fetal heart scan (fetal echo): what happens next?

This page explains about fetal heart scans carried out by the Fetal Cardiology Service at Great Ormond Street Hospital (GOSH). It explains what happens after you have had the scan and what you can expect before and after your baby is born. The Fetal Cardiology Service is part of the Cardiothoracic Team at Great Ormond Street
Hospital (GOSH). We are a team of experienced doctors, nurses and sonographers (ultrasound radiographers) who specialise in the care of babies with heart conditions both before and after birth.

Although we are based at GOSH, we hold clinics in specialist centres and other hospitals. We provide
support and information to any family whose unborn baby may have a heart abnormality.

The aim of the Cardiothoracic Team is to develop a close and supportive partnership with parents and their children to ensure a positive experience for both the families/carers and ourselves. We recognise that the hospital environment can prove to be demanding, worrying and intense and we aim to alleviate some of the stress to families by talking openly, listening to each other and working together in the best interests of the child. This way we hope to create a partnership with families that is built on mutual respect and trust.

As you know, a fetal heart scan is similar to the routine scans that you have during pregnancy, but focuses specifically on your baby’s heart. We use ultrasound to take pictures of the heart to see how it is developing and to look at the blood flow around it. In most cases, it is to check that the heart is developing normally.

Many heart problems can be detected during pregnancy but a small number can only be detected after birth.
In your case, a problem has been identified, so we will explain all the options available to you and
whether your baby is likely to need medical and/ or surgical treatment and when the treatment is likely to be needed.

As your baby has a heart problem, we will monitor their heart during pregnancy. You may need to come back for more scans of your baby’s heart before birth. Some babies with a heart condition will have problems with other body organs. The group of genes that are responsible for the development of these organs are called
chromosomes and your baby may be at risk of abnormality. If we think that this may be the case, we will discuss this with you and refer you to your local obstetrician (doctor specialising in pregnancy) for further support and specialists tests if appropriate.

Throughout your pregnancy, we will work closely with your local obstetrician, family doctor (GP) and midwife. We will write a report on your scan and send a copy to you and your local team. Your local obstetrician will discuss with you the best way to deliver your baby. There may be obstetric reasons why you may not be able to have a normal delivery. There are a few instances where a baby with a heart condition will need to be delivered by caesarean section. We will also discuss the best place for your baby to be born. Normally this will
be at your local hospital. Sometimes babies may need treatment soon after birth and will need to be delivered in a maternity centre closer to GOSH – usually at University College London Hospital (UCLH) which is about fifteen minutes’ walk from GOSH – so that your baby can be transferred to us quickly.

If your baby requires treatment immediately after birth, you can come to stay with them when you have been discharged from the maternity unit. You will be able to have follow-up care from local midwives who hold clinics at GOSH. Please see our information sheet Coming to GOSH soon after birth.

Your partner may be able to stay with you as well, depending on the unit on which your baby is being nursed. In most circumstances, we can accommodate at least one parent during your baby’s stay with us.

Before your baby is born, we can arrange for you to visit the areas at GOSH where your baby is likely to be nursed and discuss with you what you will need to bring into hospital for your baby. The Cardiac unit has a multi-disciplinary team that you can meet before or after the birth to discuss any issues or concerns you may have for yourselves, your unborn child or their siblings. If you talk to us about what your specific needs are, we can refer you to the appropriate person.

Your baby will be under the care of a cardiologist (doctor specialising in the heart) after birth. This may be the doctor who saw you during your pregnancy or another doctor who specialises in treating babies and children born with heart problems. Each baby’s needs and treatment will vary. Your baby may need input from other teams at GOSH, such as dietitians, speech therapists and physiotherapists. Specialist cardiac nurses can be
contacted at all times and there will be a nurse allocated to look after your baby on each shift.

When your baby leaves hospital, we will work closely with your local doctors, health visitors, community nurses, hospital and other services to ensure that you and your family have the support that you may need.

If your baby does not need treatment immediately after birth, your local paediatrician (doctor specialising in children’s health) will assess your baby before you are discharged from the maternity unit and refer your baby to GOSH so that they can have regular outpatient appointments for check-ups and monitoring. This
may be at GOSH or at your local hospital if the team holds clinics there.

We want to give you as much support as you need both before and after your baby is born. We are happy to answer any questions about your scan, your baby’s heart problem or any choices regarding treatment. We can also refer you to the appropriate service(s) for help in managing emotionally, financially and in how to talk to your other children about what is going to happen.